[1]郝焰,吴青青**①,卢丹,等.腹腔镜子宫肌瘤剔除术后子宫瘢痕影像消失的研究[J].中国微创外科杂志,2018,18(8):703-706.
　Hao Yan*,Wu Qingqing,Lu Dan*,et al.Study on Disappearance of Scar Images After Laparoscopic Myomectomy[J].Chinese Journal of Minimally Invasive Surgery,2018,18(8):703-706.
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腹腔镜子宫肌瘤剔除术后子宫瘢痕影像消失的研究()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年8期
页码:
703-706
栏目:
临床研究
出版日期:
2018-10-30

文章信息/Info

Title:
Study on Disappearance of Scar Images After Laparoscopic Myomectomy
作者:
郝焰; 吴青青**①; 卢丹; 郑萍; 吴霞; 周琦; 盛洁; 魏薇; 段爱红; 李慧; 李斯静①
首都医科大学附属北京妇产医院妇科，北京100026
Author(s):
Hao Yan*;  Wu Qingqing;  Lu Dan*;  et al.
*Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
关键词:
腹腔镜子宫肌瘤剔除术; 瘢痕; 愈合
Keywords:
Laparoscopic myomectomy; Scar; Healing
文献标志码:
A
摘要:
目的探讨腹腔镜子宫肌瘤剔除术后子宫瘢痕愈合时间。方法选择2016年1~12月子宫肌瘤剔除术，单发子宫肌瘤，肌瘤直径5~9 cm，采用国际妇产科联盟（FIGO）子宫肌瘤9型分类方法，选择Ⅴ型（肌瘤贯穿全部子宫肌层）及突出浆膜层<50%的Ⅵ型（肌瘤突向浆膜）子宫肌瘤，最终完成随访Ⅴ型52例，Ⅵ型34例。术后2周、1个月、3个月，之后每3个月一次于月经干净10天内行阴道超声，将超声下瘢痕部位恢复正常子宫肌层回声界定为瘢痕消失。结果术后3个月前均未发现有子宫瘢痕消失，Ⅴ型术后6、9、12个月瘢痕消失率分别为15.4%（8/52）、59.6%（31/52）、92.3%（48/52），Ⅵ型分别为79.4%（27/34）、94.1%（32/34）、100%（34/34），术后6、9个月Ⅵ型均明显高于Ⅴ型(χ2=34.920、12.491，P均=0000)，术后12个月2组无统计学意义(χ2=1.283，P=0.257)。结论Ⅴ型子宫肌瘤剔除术后瘢痕影像多于9~12个月消失，突出浆膜层<50%的Ⅵ型子宫肌瘤剔除术后瘢痕多于6~9个月消失。阴道超声可用于监测腹腔镜子宫肌瘤剔除术后子宫瘢痕消失情况。
Abstract:
ObjectiveTo explore the disappearing of scar images of the uterus after laparoscopic myomectomy.MethodsPatients planned for laparoscopic myomectomy surgery from January 2016 to December 2016, with myomas 5-9 cm in diameter, were included in this study. According to the uterine fibroids 9 type classification method of International Federation of Gynecology and Obstetrics (FIGO), the type Ⅴ (fibroids throughout all myometrium) and type Ⅵ (fibroids protruding toward serosa) fibroids with highlight the serosa layer < 50% were selected. Follow-ups were completed in 52 cases in the type Ⅴ group and 34 cases in the type Ⅵ group. Vaginal ultrasound was performed at 2 weeks, 1 month, and 3 months after operation, as well as every 3 months afterwards (within 10 days after menstruation). The scar ultrasonic echoes recovering to normal myometrium was defined as scar disappearance.ResultsNo uterine scar disappeared within 3 months after surgery. The scar disappearing rates in the type Ⅴ group at 6, 9 and 12 months after operation were 15.4% (8/52), 59.6% (31/52), and 92.3% (48/52), respectively, and those in the type Ⅵ group were 79.4% (27/34), 94.1% (32/34), and 100% (34/34), respectively. At 6 and 9 months after the operation, the scar disappearing rates in the type Ⅵ group were significantly higher than those in the type Ⅴ group (χ2=34.920, 12.491; P=0.000, 0000). There was no statistical significance in the 2 groups at 12 months after surgery (χ2=1.283, P=0.257).ConclusionsThe disappearing scar images usually happen in 9-12 months after operation for type Ⅴ fibroids, and 6-9 months after operation for type Ⅵ fibroids (highlight the serosal layer < 50%). Vaginal ultrasonography can be used to monitor the disappearance of scar images after laparoscopic myomectomy.

参考文献/References:

[1]景明来,王芬娟,龚巧丽.腹腔镜与开腹子宫肌瘤剔除术的比较.中国微创外科杂志,2013,13(4):333-335.
[2]Sizzi O，Rossetti A，Mahoni M，et al．Italian multieenter studyon complications of laparoseopic myomectomy．J Minim Invasive Gynecol，2007，14：453-462．
[3]李玲,于昕,郎景和.子宫肌瘤/腺肌瘤剔除术后妊娠子宫破裂的临床研究.生殖医学杂志，2015，24（3）：195-199.
[4]子宫肌瘤的诊治中国专家共识专家组.子宫肌瘤的诊治中国专家共识.中华妇产科杂志,2017,52(12):793-800.
[5]Seracchioli R，Venturoli S，Colombo FM，et al.GnRH agonist treatment before total laparoscopic hysterectomy for large uteri.J Am Assoc Gynecol Laparosc,2003,10(3):316-319．
[6]蔡兴苑,卢丹,代荫梅.腹腔镜子宫肌瘤剔除术后影响患者妊娠结局的多因素分析.中国微创外科杂志,2015,15(9):769-772.
[7]段爱红, 卢丹.子宫肌瘤切除术后妊娠时机的选择.中华临床医师杂志（电子版）,2013,7(4):1400-1402.
[8]田玉翠，王红梅，薛智方，等.子宫肌瘤剔除术后妊娠发生不完全性子宫破裂的临床危险因素分析.北京医学,2014，36（11）:987-989.
[9]宋光辉,张英,李百加.腹腔镜下子宫肌瘤剔除术后妊娠结局及相关因素分析.中华医学杂志,2013,9,17(93):2816-2819.
[10]Paul PG，Koshy AK，Thomas T.Pregnancy outcomes following laparoscopic myomectomy and single-layer myometrial closure.Hum Reprod，2006，21:3278-3281.
[11]Soriano D,Dessolle L,Poncelet C,et al.Pregnancy out come after laparoscopic and laparoconverted myomectomy.Eur J Obstet Gynecol Reprod Biol,2003,108(2):194-198.
[12]Darwish AM,Nasr AM,El-Nashar DA. Evaluation of postmyomectomy uterine scar.J Clin Ultrasound,2005,33(4):181-186.
[13]Chang WC,Chang DY,Huang SC.Use of three-dimensional ultrasonography in the evaluation of uterine perfusion and healing after laparoscopic myomectomy.Fertil Steril,2009,92(3):1110-1115.
[14]Andrea T,Bradley S,Liselotte M.Ultrasound evaluation of uterine healing after laparoscopic intracapsular myomectomy:an observational study.Hum Reprod,2012,27(9):2664-2670.

备注/Memo

备注/Memo:
基金项目：首都医科大学附属北京妇产医院中青年学科骨干培养专项（FCYY201519）**通讯作者，E-mail：wuqq2007@163.com①超声医学科
更新日期/Last Update: 2018-10-30